Fatigue In Hormone-Naive Prostate Cancer Patients Treated With Radical Prostatectomy Or Definitive Radiotherapy

Main Category: Prostate / Prostate Cancer
Article Date: 19 Mar 2010 - 4:00 PDT


UroToday.com - In the online edition of Prostate Cancer and Prostatic Diseases, a group of Norwegian investigators report on the prevalence of chronic fatigue (CF) in hormone-naïve patients who underwent radical prostatectomy (RP) or radiotherapy (RT) at least one year prior to the survey.

Fatigue is a multidimensional symptom defined as the "subjective feeling of tiredness, weakness or lack of energy." If the symptoms of fatigue last more than 6 months it is referred to as CF. The frequency of CF as a late effect after treatment for prostate cancer (CaP) is 15-40% after RT and 10-17% after RP. To assess the prevalence of CF in hormone-naïve patients, the Cancer Registry of Norway was used to identify patients. CaP stage, Gleason score, age and the time of RP or RT were recorded. Patients using androgen deprivation therapy were identified and excluded. A survey was sent to 2,998 CaP patients in 2006 and 2,194 responded (73%). A subset of 531 met the entry criteria for inclusion in this analysis (more than one year since RP or RT and no history of ADT use. CF was assessed using The Fatigue Questionnaire, which evaluates physical fatigue and mental fatigue and the Total Fatigue Score is calculated from these. The Brief Sexual Function Inventory assessed sexual function with a range from 0 to 40 and a higher score implying better sexual function. Bodily pain, neuroticism, urinary dysfunction, intestinal dysfunction and level of education and relationship status were assessed.

Of the 531 eligible patients, 521 returned a completed questionnaire, 337 who underwent RP and 184 who underwent RT. The median observation time was 23 months and median age was 65 years. RT patients were older and had higher D'Amico risk stratification. More patients in the RT group compared to the RP group reported post-treatment co-morbidity and pain. CF was reported by 17.9% of the survey respondents - 13.4% after RP and 26.1% after RT. This CF prevalence difference between RP and RT men was most prominent in those with the longest observation time. In multivariate analysis, survivors after RT were twice as likely to report CF as compared with RP. High neuroticism, presence of co-morbidities, pain and urinary and intestinal dysfunction remained positively associated with CF in the multivariate analysis.

Kyrdalen AE, Dahl AA, Hernes E, Cvancarova M, Fosså SD

Prostate Cancer Prostatic Dis. 2010 Jan 26. Epub ahead of print. doi:10.1038/pcan.2009.61

Written by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice. To access the latest urology news releases from UroToday, go to: www.urotoday.com

Copyright © 2010 - UroToday

• Additional
• References
• Citations